Intravascular cervical sympathetic nerve stimulation system

Abstract

The disclosed subject matter provides techniques for treating a subject. An example method includes placing a lead in a vertebral vein of the subject, placing at least one electrode within the vertebral vein adjacent to an autonomic nerve, and modulating a cardiovascular system of the subject by supplying a predetermined amount of an electrical stimulation energy to the autonomic nerve. In non-limiting embodiments, the lead can be placed in the vertebral vein via a subclavian vein, an axillary vein, or a combination thereof. In some embodiments, the at least one electrode can be coupled to the lead.

What is claimed is: 
     
         1 . A method of treating a subject with an electronic device for neuromodulation, comprising:
 placing a lead in a vertebral vein of the subject, wherein the lead is placed in the vertebral vein via a subclavian vein, an axillary vein, or a combination thereof;   placing at least one electrode within the vertebral vein adjacent to an autonomic nerve, wherein the at least one electrode is coupled to the lead; and   modulating a cardiovascular system of the subject by supplying a predetermined amount of an electrical stimulation energy to the autonomic nerve.   
     
     
         2 . The method of  claim 1 , wherein the method comprises inducing an arrhythmia. 
     
     
         3 . The method of  claim 2 , wherein the method further comprises identifying a site of origin based on the arrhythmia. 
     
     
         4 . The method of  claim 3 , further comprising guiding an ablation based on the arrhythmia. 
     
     
         5 . The method of  claim 1 , wherein the electronic device is implantable. 
     
     
         6 . The method of  claim 5 , further comprising placing a pulse generator that is coupled to the lead. 
     
     
         7 . The method of  claim 5 , wherein the electrical stimulation energy is continuous or titrated. 
     
     
         8 . The method of  claim 5 , wherein the electrical stimulation energy is delivered at a magnitude of stimulation to avoid incidental stimulation of muscle. 
     
     
         9 . The method of  claim 6 , wherein the modulating the cardiovascular system of the subject comprises inhibiting an activity of the autonomic nerve via a closed loop system function of the pulse generator when a ventricular arrhythmia is detected from the subject. 
     
     
         10 . The method of  claim 6 , wherein the modulating the cardiovascular system of the subject comprises activating an activity of the autonomic nerve via a closed loop system function of the pulse generator when a thoracic impedance of the subject increases. 
     
     
         11 . The method of  claim 5 , wherein the at least one electrode is located longitudinally along a distal aspect of the lead. 
     
     
         12 . The method of  claim 5 , wherein the electrode is positioned with a directional bias in around the lead diameter. 
     
     
         13 . The method of  claim 5 , where the electrode is directed toward the autonomic nerve. 
     
     
         14 . The method of  claim 5 , wherein the lead comprises a guidewire lumen. 
     
     
         15 . The method of  claim 14 , further comprises
 inserting the guidewire lumen at least one centimeter into the vertebral vein; and   advancing the lead over the guidewire.   
     
     
         16 . A system for treating a subject with an electronic device for neuromodulation, comprising:
 a lead configured to be inserted into a vertebral vein of the subject via a subclavian vein, an axillary vein, or a combination thereof;   at least one electrode coupled to the lead, wherein the at least one electrode is configured to be placed in the vertebral vein adjacent to an autonomic nerve, wherein the at least one electrode is coupled to the lead; and   a pulse generator coupled to the lead, wherein the pulse generator is configured to supply an electrical stimulation energy to the autonomic nerve through the lead.   
     
     
         17 . The system of  claim 16 , wherein the system is for guiding a cardiac ablation procedure. 
     
     
         18 . The system of  claim 16 , wherein a frequency of the electrical stimulation energy ranges from about 0.9 Hz to about 10 kHz. 
     
     
         19 . The system of  claim 17 , wherein the amplitude of electrical stimulation ranges from about 2-20 mA. 
     
     
         20 . The system of  claim 16 , wherein the electronic device is implantable. 
     
     
         21 . The system of  claim 20 , wherein a diameter of the lead ranges from about 0.6 mm to about 2.5 mm. 
     
     
         22 . The system of  claim 20 , wherein the lead comprises a tapered distal tip with a bend for positioning in the vertebral vein and ensuring contact with the autonomic nerve. 
     
     
         23 . The system of  claim 20 , wherein the lead comprises up to about 20 electrodes. 
     
     
         24 . The system of  claim 20 , where the lead is configured to exert a bias force to retain a distal top of the lead substantially immobile. 
     
     
         25 . The system of  claim 20 , wherein the lead is configured to detect an electrical energy corresponding to a ventricular contraction, a thoracic impedance, or a combination thereof. 
     
     
         26 . The system of  claim 20 , wherein the pulse generator is configured to detect ventricular arrhythmias based on a rate of a ventricular activity and a direction of activation. 
     
     
         27 . The system of  claim 20 , wherein the pulse generator is a battery powered pulse generator.